Countdown: Our Last, Best Hope for a Future on Earth?

by Alan Weisman

  Figueres reasoned that it was easier—and cheaper—to keep the citizenry pacified with schools, health care, and social security than with a standing army ready to suppress internal unrest. On his coffee finca in southern Costa Rica, he’d learned that paying laborers fairly, and providing them medical care and free milk for their children from his dairy, assured him of a loyal workforce. Within a year of his coup he had converted former army barracks to schools, held elections, and stepped down from the interim presidency. A few years later, he was elected democratically, and reelected twice thereafter.

  The success of his revolution involved some lucky timing. With a Cold War between world capitalism and world communism incubating, the United States was too preoccupied with a sinking situation in Korea to worry about a Central American backwater. Had Costa Rica happened five years later, post–Korean War, Figueres’s fate might have been that of Guatemalan president Jacobo Árbenz Guzmán, whom the CIA removed in 1954 before his land reforms could expropriate United Fruit Company banana plantations—or that of Iranian prime minister Mohammad Mosaddegh, ousted in 1953, also by the CIA, for nationalizing Iran’s oil industry.

  By then, Figueres had long since nationalized Costa Rican banks, enfranchised women and black voters, extended health services, and guaranteed higher education throughout the country. The resulting stability was so applauded by labor and business alike that the United States overlooked his suspect populism, especially after Fidel Castro’s 1959 Cuban revolution. With Soviet money propping up Cuba like a billboard for communism in Latin America, the United States needed one for capitalism, and the most dependable democracy in the region was the obvious choice. In 1961, President Kennedy created the United States Agency for International Development, to lavish generosity on countries friendly to U.S. interests. USAID’s mission in Costa Rica was one of its biggest, bestowing eight times more foreign aid per capita than anywhere else in Latin America.

  It was also among the first places where the United States sent contraceptives. At the time, Costa Rica had one of the world’s fastest-growing populations, with families averaging between seven and eight children. Thanks to the improved public health care Figueres instituted, most were now tending to survive—a blessing that resulted in an unexpected explosion of numbers. America’s foray into family planning abroad, like its policy of buying foreign friendship, was not without controversy. The pills that USAID began distributing in Costa Rica in 1966 were the result of drug trials conducted on a Caribbean island that, to this day, still besmirch the cause of reproductive health.

  In 1934, the United States began its first governmental birth control program—in Puerto Rico, which Theodore Roosevelt had persuaded his government to keep as spoils of the 1898 Spanish-American War. Roosevelt’s plan for Puerto Rico was a U.S. naval base and coaling station for ships using the canal he dreamed of digging through the Central American isthmus. Eventually, it all came to pass: The Panama Canal made the United States a world economic center, and the biggest American naval base, on Puerto Rico’s eastern shore, helped make it a world military power.

  Unlike the transcontinental country to which it now belonged, Puerto Rico was an island only a hundred miles long and thirty-five miles wide, without much room for its population to expand. Yet it was doing so anyway. Beginning the nineteenth century with a hundred fifty thousand people, Puerto Rico ended it with a million. The acquisition of a small, crowded isle of brown-skinned people who didn’t speak English alarmed more than a few Americans. Although Puerto Ricans would be granted citizenship in 1917—in part to blunt accusations that the United States, born of a revolt against colonialism, was now a colonial power itself—even today they are denied voting in Congress or in national elections.

  But Puerto Ricans could be useful. Since World War I, they have been drafted, with many dying in U.S. foreign wars. During World War II, Puerto Rican soldiers were experimentally sprayed with mustard gas to see if they were more resistant than Caucasians. And in the 1950s, Puerto Rican women became human lab mice for testing birth control pills that later were sent to Costa Rica—although by then, with only one-third of the estrogen and one-hundredth of the progesterone of those used in the Puerto Rican trials.

  Scores of Puerto Rican women taking the original high-dosage pills experienced nausea, dizziness, headaches, blurred vision, bloating, or vomiting. Some suffered blood clots and strokes. The ones who died were never autopsied. None, it has been widely reported, had been informed that, except for a short trial in Boston, the new medication from G. D. Searle and Company wasn’t field-tested—nor that they were the test. They were simply told that the tablets prevented pregnancy.

  When the truth emerged, no one was particularly surprised. Puerto Rican women had already been subjected to what, until Zyklon B started hissing out of Nazi showerheads, was the most sweeping policy ever based on eugenics, a pseudoscientific distortion of Charles Darwin’s theory of natural selection. During the first three decades of the twentieth century, eugenics was taught in hundreds of European and American universities, including Harvard and Yale. Among its advocates were Theodore Roosevelt, Winston Churchill, Alexander Graham Bell, breakfast cereal magnate J. H. Kellogg, several Scandinavian governments, and Margaret Sanger, the founder of Planned Parenthood. Although Darwin himself was not a proponent, his son Leonard presided over the First International Congress of Eugenics, held in London.

  The term eugenics is attributed to Darwin’s cousin, Sir Francis Galton, a scientist who claimed a biological rationale for Britain’s ruling classes: namely, superior genes. This assertion soon broadened into a theory of social and economic survival of the fittest called Social Darwinism. Its purported scientific logic reassured elites that some races, especially their darker-skinned colonial subjects, were inferior to others. In America, eugenics became the pretext for legitimized prejudice, including anti-miscegenation laws in several states. It spawned organizations such as Kellogg’s Race Betterment Foundation, which promoted the improvement of humanity by careful breeding through racial segregation, lest the gene pool be tainted.

  Margaret Sanger’s embrace of eugenics involved not so much qualities to be nurtured as those to be eliminated. Her belief that the “mentally unfit” should be sterilized, conflated with her work to bring contraception to minority groups, made Planned Parenthood suspect of racism and even of plotting genocide against minorities. These charges still surface, even though luminaries like Martin Luther King Jr. were among Sanger’s supporters. Although she had helped secure funding that led to development of the pill and its Puerto Rican field trials, the genocide claim concerned something with which she had little direct involvement: a mass sterilization program in Puerto Rico that began during the 1930s, and which never really ended.

  Its messy context was the inept relationship of the anticolonial United States to its colonial possession. Until the late 1940s, every governor of Puerto Rico was an appointed male Caucasian mainlander, who could veto anything passed by its legislature. English was mandatory in federal courts on the island (it still is) and in schools, resulting in Spanish-speaking teachers being required to teach Spanish-speaking students in a language neither understood very well.

  The prevailing acceptance of eugenics contributed to the widespread prejudicial notion on the mainland that Puerto Ricans were somehow inferior. Not until Hitler, eugenics’ most ardent devotee, would the criteria of scientists who propounded it be questioned. For years, Harvard genetics students were taught that alcoholism, criminal behavior, and “feeble-mindedness”—a term Margaret Sanger also used—were inherited traits to be rooted out through breeding. According to Harvard science historian Everett Mendelsohn, their textbook stated that “the biologically poorest elements” reproduced faster than “the intellectual and cultural elements.”

  Against this stacked deck was the fact that Puerto Rico was becoming seriously overcrowded. By the 1930s, nearly another million had been added. (Like the planet, Puerto Rico’s numbers would
quadruple in the twentieth century; its current population, 4 million, doesn’t include 4 million more puertorriqueños living in the mainland United States—to which, as U.S. citizens, they can emigrate freely.) In 1934, with unemployment rising as fast as the population, sixty-seven federally funded birth control clinics were opened on the island through a special Puerto Rican Emergency Relief Fund. With the situation classified as an emergency, doctors were literally encouraged to cut with surgical swiftness.

  Back then, there weren’t many options for reliable contraception. Margaret Sanger herself imported the first diaphragms and French pessaries—cervical caps—into the United States, in open defiance of the 1873 Comstock Act that outlawed sending “obscene, lewd, and/or lascivious” materials through the mail. Even condoms were illegal until Sanger finally won court judgments acknowledging their role in preventing disease (sadly, too late to benefit U.S. World War I servicemen, who had the highest gonorrhea and syphilis rates among Allied forces). Sanger, an Irish-American Catholic whose mother died at forty after eleven children and multiple miscarriages, was a nurse and reformer for women’s rights. Each time she went to jail, Sanger amassed more support for her contraceptive cause—but those supporters also included eugenicists, appalled at how “the unfit” were multiplying.

  In several U.S. states, tubal ligation—severing or blocking a woman’s Fallopian tubes—was allowed for enforced sterilization on alleged mental defectives, criminals, and others deemed genetically unsuitable, including people born with physical impairments. In Puerto Rico, sterilization was considered simpler and more reliable than the prophylactic or barrier devices Sanger eventually got legalized. It was usually performed postpartum, to insure that a woman’s latest pregnancy would be her last. Routinely, however, she wasn’t told that it was permanent. (According to women’s groups against imposed sterilization, the euphemism getting your tubes tied implied that the procedure was reversible.) Even after the shock of Hitler curtailed the American eugenics movement,1 the program in Puerto Rico grew. By the mid-1960s, according to numerous studies, more than one-third of Puerto Rican women of child-bearing age had been sterilized—ten times the mainland rate. To put that in perspective: In 1977, when a coercive mass sterilization program in India tumbled the government of Prime Minister Indira Gandhi, the figure was 5 percent.

  Today in Puerto Rico, the phrase la operación remains synonymous with sterilization. However, even as feminists and Puerto Rican independentistas alike cite it as proof of the colonial power’s racism and sexism, the reaction of most Puerto Rican women has been simply to shrug. For decades now, they mostly live in cities, want jobs, and want to stop having children after two—or even fewer: Puerto Rico’s fertility rate has now dropped to 1.62 children per woman. A tubal ligation is easier than getting men to wear condoms, or keeping track of—or having to buy—birth control pills. Despite abuse investigations that eventually led to sterilization guidelines on both the island and the mainland, by the 1980s the percentage of puertorriqueñas who had la operación climbed past 45 percent, the highest in the world. Among Puerto Rican women wherever they live, says anthropologist Iris Lopez, “It is now a tradition.”

  As Ronald Reagan would note with wonder when he first visited Latin America as president, “They’re all different countries down there.” Latin American tastes toward family planning vary by locale, and Costa Rica, unlike Puerto Rico, wasn’t the USA’s colony, but its billboard. A bludgeon approach to population control by foisting tubal ligations on independent Costa Rica would have been no way to treat a poster country.

  “In fact,” says Hilda Picado, tapping her desk with brown-rimmed rectangular glasses, “sterilization was a titanic struggle here. A doctor had to agree the need was urgent. The husband’s permission was required. And it was only allowed if a woman already had three children.” A 1998 law finally gave Costa Rican women the right to choose it for any reason. But in a country where Catholicism is still the official state religion, reproductive rights were won in slow increments.

  Hilda Picado is director general of the national Asociación Demográfica Costarricense. Her office is in a pastel condominium in La Uruca, a former coffee finca in Costa Rica’s central highlands northeast of the capital, San José. Two generations ago, San José was small enough that the aroma from mounds of coffee beans in the central market pervaded much of the city. Then, the children of Costa Rican women, who had been reproducing faster than almost anyone else on Earth, reached adulthood and spawned their own families. San José soon engulfed ten surrounding villages, including La Uruca, and now smells mainly of diesel and damp concrete.

  Hilda Picado’s father was one of twelve. Two of her uncles also had twelve. “Twelve wasn’t that many. I knew families with sixteen, eighteen, twenty.” Picado, born in 1960, was one of six. Her mother would have had more, but toward the end of the 1960s, two things happened.

  The first, in 1966, was USAID’s infusion of birth control pills into the clinics that President Figueres built, along with money to develop the organization Hilda now directs.

  It was no coincidence that this occurred shortly after the Second Vatican Council ended. Convened by Pope John XXIII early in his five-year papacy, Vatican II was intended to modernize Catholic Church practices. It permitted vernacular language in the previously all-Latin Mass, embraced ecumenism, unveiled women, and was widely welcomed as refreshing spiritual renewal. Many Catholic intellectuals, theologians, and even clergy believed that, especially with the recent appearance of birth control pills, a major shift of church doctrine regarding contraception was now inevitable. The Pope even appointed a commission to study the matter. Although John XXIII died of stomach cancer before the study was completed, momentum for change seemed great; even his more conservative successor, Pope Paul VI, continued Vatican II and expanded the contraception study, and it was widely assumed that the Church’s proscription on birth control would be overturned.

  That was especially true in Latin America, where the divergent spirits of Vatican II and the Cuban revolution intersected in a movement called Liberation Theology. Throughout the region, nuns doffed their habits and dressed like the people they served, and priests preached against social and economic injustice. Liberation Theology’s defense of the oppressed especially embraced women. Amid this exhilaration, the introduction of oral contraceptives into Costa Rica and its Latin American neighbors met only token opposition from Catholic clergy.

  In 1966, by a 69–10 majority, clerical and lay members of the Papal Commission on Population and Birth Control voted to annul the church’s prohibition. Five minority members submitted a dissenting opinion, based largely on the writings of a Polish archbishop, Karol Wojtyła, who would later become pope himself. To reverse the proscription on birth control, the dissenters held, would undermine papal infallibility. After both opinions were leaked to the press before any papal action had been taken, an angry Pope Paul VI responded with an encyclical, Humanae Vitae, that sided with the minority.

  Humanae Vitae was a shock, but it came too late. By 1968, pills were everywhere. In officially Catholic Costa Rica, even the Ministry of Health distributed them, through its new Office of Population. The popularity of its family-planning program was aided by the second thing that dissuaded Hilda Picado’s mother from having more children: a message coming over the radio into the Picados’ kitchen, never heard before on Costa Rican airwaves.

  “Let’s not be embarrassed to discuss what God wasn’t embarrassed to create,” it said.

  It was church-sanctioned sex education programming, including information about how to acquire and use birth control. But the clergy behind the broadcasts weren’t Catholic: after Humanae Vitae, priests or nuns who counseled their flocks to use contraception did so at peril of excommunication.

  “It was los evangélicos!” recalls Hilda Picado, beaming. They were Pentecostals, Baptists, Wesleyans, Methodists, Moravians, Mennonites, Presbyterians, and others that had banded together to form the Evangelical Cos
ta Rican Alliance, after José Figueres’s peaceful coup. With this united front against anti-Protestant pressure from the official Catholic Church, their hope was to gain space for alternatives in the new Costa Rica. Even before the pill, they had spotted and begun to exploit their adversary’s weakness.

  By the early 1960s, evangelical “Good Will Caravans” roamed the country, spreading contraceptive advice and even offering vasectomies along with the Gospel. When birth control pills became available, they included that information with the other good news on their radio programs and helped the government distribute them. God, they assured listeners, loved them for wanting to have the number of children they could comfortably support. No one was going to hell, nor even had to ask forgiveness for something so reasonable. Having fewer children, they said, meant a better chance to escape poverty. By stressing that preventing pregnancy in the first place was the best way to avoid having an abortion, they beat the Catholics at their own game.

  “The Bible gives you the freedom to decide what to do with your own life,” says Hilda Picado, a Jehovah’s Witness. To explain in part Costa Rica’s incredible reversal in fertility rates—from 7.3 children per family in 1960 to 3.7 by 1975, to 1.93 by 2011—and the reason why nearly all of Latin America is approaching replacement rate, she points to the simultaneous defection rate of Catholics who have joined evangelical sects in the last fifty years: By some estimates, Latin America will have a Protestant majority before the end of this century.

  Picado is currently battling conservative Catholic groups like Opus Dei to legalize the morning-after pill. “You need a backup if whatever you’re using fails. Condoms break, or sperm spills over. Women forget to take a pill. Most important, women who get raped need it.”

  Without it, she reminds opponents, the only other backup is abortion, which is illegal in Costa Rica, and which neither Picado nor her organization supports, even though they’re part of the International Planned Parenthood Federation. She cites a 2007 study that estimates twenty-seven thousand annual illegal abortions in Costa Rica. As everywhere, they account for more emergency hospitalizations than nearly anything except traffic accidents.